Question

Osteomyelitis- Diagnosis, pathophysiology related to client problem, health promotion and disease prevention, risk factors, expected findings, Lab tests, diagnostic procedures, nursing care, medications , client education, safety considerations and complications.

Answer 1

Osteomyelitis : it is the inflammation of bone by bacteria or fungus.

diagnosis: by history and physical examination

• history of staph aureus, group b streptococcus, hemophilus influenzae infection.
• presence of fever, sweating, chills in general and local symptoms include limitation of movement , swelling and pain.
• lab tests include wbc count, erythrocyte sedimentation rate,bone scan, mri, c reactive protein.

pathophysiology: because of risk factors mentioned below, infective organism multiplies and causes inflammatory reaction. It causes local ischemic necrosis of bone and forms abscess. Abscess formation increases intramedullary pressure. Abscess comes out into subperiosteal space and forms there. Periosteum is lifted away from bone which causes bone ischemia. Extreme sequestra formation occurs and chronic osteomyelitis forms.

disease prevention and health promotion: intake of healthy diet and adopting healthy lifestyle

• complete treatment of infections

risk factors: trauma, malnutrition, chronic illness, compromised immune system , radiation fibrosis, hiv aids

lab tests: increased white blood count, erythrocyte sedimentation rate, c reactive protein.

diagnostic procedure: magnetic resonance imaging , x rays , bone scan to find out the site of bone infected,

bone biopsy is gold standard.

nursing care:

• Assess the area for swelling, warmth and pain
• plan for high calorie high protein diet
• administer antipyretics, analgesics, antibiotics as prescribed
• prevention of infection by practising hand washing etc.
• assess intravenous site

medications: analgesics, antibiotics

Patient education:

• to educate the patient about importance of healthy diet.
• to avoid injury at the site of infection
• To take medicine as directed

safety considerations:

• avoid injury at site of infection
• take well balanced diet
• practise good hygiene and hand washing to avoid infection.

Complications : septicemia , septic arthritis, pathological fracture, chronic osteomyelitis, growth disturbances